Archive. Hong Kong: HFMD and EV71 cases with neurological complications, cases' list (2010)

[Giuseppe]

Hong Kong: Laboratory result of neurological complication suspected to be caused by EV infection (6/8/10): Echovirus 9 confirmed

Hong Kong: Laboratory result of neurological complication suspected to be caused by EV infection (6/8/10)

[Source: Centre for Health Protection, Hong Kong PRC SAR, View Original Article.]

The Centre for Health Protection (CHP) of the Department of Health today (June 8) received the laboratory test result of a case of neurological complication suspected to be due to enterovirus (EV) infection.

The patient, previously confirmed to have EV infection with meningitis complication, is a 23-year-old male student admitted to Kwong Wah Hospital. His rectal swab specimen tested positive for Echovirus type 9. He has recovered and was discharged from hospital last Saturday. Results from sampling of his home contacts were all negative.

Echovirus is a type of EV and can also cause hand, foot and mouth disease (HFMD).

Complications, which are rare, include meningitis and encephalitis.

The spokesman reminded the public to maintain strict personal and environmental hygiene during the current HFMD outbreaks and to adopt the following preventive measures:

• Maintain good air circulation;
• Wash hands before meals and after going to the toilet, handling diapers or other stool soiled materials;
• Keep hands clean and wash hands properly, especially when they are made dirty by respiratory secretions, such as after sneezing;
• Cover nose and mouth while sneezing or coughing and dispose of nasal and mouth discharge properly;
• Clean children's toys and other objects thoroughly and frequently with 1:49 diluted household bleach, followed by rinsing/wiping with clean water;
• Children who are ill should be kept out of school until their fever and rash have subsided and all the vesicles have dried and crusted; and
• Avoid going to overcrowded places.

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[Giuseppe]

Hong Kong: SFH on hand, foot and mouth disease (6/8/10): 300+ institutions affected so far

Hong Kong: SFH on hand, foot and mouth disease (6/8/10)

[Source: Govt of Hong Kong PRC SAR, View Original Article.]

Following is the transcript of remarks (English portion) made by the Secretary for Food and Health, Dr York Chow, at a media stand-up session in the Legislative Council Building today (June 8):

Reporter:
The number of institutional outbreaks of hand, foot and mouth disease has been more than 300. Do you think the Government is doing enough to contain the outbreak? How concerned are you?

Secretary for Food and Health:
We are of course really concerned about this peak period of hand, foot and month disease. As explained by Dr Thomas Tsang, we are reaching the peak of the season. We have already briefed operators of the kindergartens and child care centres and so on in March and April, and also informed all medical practitioners about the potential increase of cases this year. But as you see that the number of cases will be oscillating at a high level in the coming weeks until perhaps the end of the school term, i.e. close to the beginning of July, this is something that our citizens need to take good care of themselves and also their children, particularly in personal hygiene because the diseases are transmitted by droplets as well as by contact.

Reporter:
Would you extend the school holidays since lots of the schools are being affected?

Secretary for Food and Health:
The Centre for Health Protection will look at each individual school to see the extent of the outbreak to decide whether they need to advise these schools to suspend classes for two weeks. If many schools are required for such changes and the escalation of numbers of the cases is beyond a certain level, of course we have to look at something more drastic. But this is something to be decided by the Centre for Health Protection.

Reporter:
(on the seriousness of EV infection and hand, foot and mouth disease)

Secretary for Food and Health:
This peak period of the enterovirus infection would perhaps last only for a month or so. It should not last like influenza for many months. This is the usual trend of hand, foot and mouth disease. This is a cycle of a peak of this infection in Hong Kong and also in this particular region.

Reporter:
Did it come earlier than expected?

Secretary for Food and Health:
Not really. Most of the time, this disease comes in early summer. So this is actually the usual time.

Reporter:
Any advice to people?

Secretary for Food and Health:
My advice to people is to ensure they look after themselves well. If they have children in the family, make sure that when they have infection, go to see a doctor and keep them at home, separate them from other children, and do not go to school or the kindergarten.

(Please also refer to the Chinese portion of the transcript)
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[Giuseppe]

Hong Kong: Vigilance urged against Hand, Foot and Mouth Disease (6/10/10): 7 year old boy hospitalized with enteroviral meningitis

Hong Kong: Vigilance urged against Hand, Foot and Mouth Disease (6/10/10)

[Source: Centre for Health Protection, Hong Kong PRC SAR, View Original Article.]

The Centre for Health Protection (CHP) of the Department of Health has repeated its call for vigilance against hand, foot and mouth disease (HFMD) as a report on an imported case of enteroviral meningitis was received from Tuen Mun Hospital (TMH) today (June 10).

The patient was a seven-year-old boy born in Hong Kong. He lives and studies on the Mainland. The boy developed fever and vesicles on the throat, hands and feet in mid-May. He sought treatment from a hospital on the Mainland. The boy developed fever again from May 25 with headache, fatigue, abdominal pain and vomiting. He attended a hospital on the Mainland again on June 3. He then came to Hong Kong on June 8 and was admitted to TMH. His cerebrospinal fluid preliminarily tested positive for enterovirus. Further laboratory results are pending. The boy is now in stable condition. His home contacts in Hong Kong are all asymptomatic.

The spokesman called on the public to maintain strict personal and environmental hygiene to prevent HFMD.

They should adopt the following measures:

• Maintain good air circulation;
• Wash hands before meals and after going to the toilet, handling diapers or other stool soiled materials;
• Keep hands clean and wash hands properly, especially when they are made dirty by respiratory secretions, such as after sneezing;
• Cover nose and mouth while sneezing or coughing and dispose of nasal and mouth discharge properly;
• Clean children's toys and other objects thoroughly and frequently with 1:49 diluted household bleach, followed by rinsing/wiping with clean water;
• Children who are ill should be kept out of school until their fever and rash have subsided and all the vesicles have dried and crusted; and
• Avoid going to overcrowded places.

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[Giuseppe]

Hong Kong: Deceased student negative for enterovirus (6/10/10)

Hong Kong: Deceased student negative for enterovirus (6/10/10)

[Source: Centre for Health Protection, Hong Kong PRC SAR, View Original Article.]

Preliminary tests by the Public Health Laboratory Centre of the Centre for Health Protection (CHP) have indicated negative result for enterovirus for the 14-year-old student of Tang Shiu Kin Victoria Government Secondary School in Wan Cha who passed away early yesterday (June 9) morning.

Further testing for other viruses is in progress.

The student complained of malaise and vomiting and attended the Accident and Emergency Department (AED) of Queen Mary Hospital on June 7. The boy was found collapsed at home and was sent to the AED of Ruttonjee Hospital in the late evening of June 8. He was certified dead in the AED.

The case was referred to the coroner.

The CHP has given advice to the school on thorough disinfection and infection control measures.

So far there was no outbreak of Hand, Foot and Mouth Disease or influenza-like illness in the school.
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[alert]

Re: Hong Kong: Deceased student negative for enterovirus (6/10/10)

I believe this is the same individual in this post that is listed as a suspect H1N1 fatality.

http://www.flutrackers.com/forum/showthread.php?t=147707

[Shiloh]

Re: Hong Kong: Deceased student negative for enterovirus (6/10/10)

Source: http://www.thestandard.com.hk/news_d...=20100611&fc=7

Mystery illness kills boy, 14

Mary Ann Benitez

Friday, June 11, 2010

The sudden death of a 14-year-old boy on Wednesday has doctors mystified, after initial tests showed he did not suffer an enteroviral infection.

This comes as the city is in the grip of an enterovirus-71 and hand, foot and mouth disease outbreak, with 369 institutional outbreaks this year.

The student of Tang Shiu Kin Victoria Government Secondary School in Wan Chai was treated at the accident and emergency department of Queen Mary Hospital on Monday after vomiting and feeling unwell.

But he was found collapsed at home the next evening and rushed to Ruttonjee Hospital.

Emergency department staff there could not revive him despite hours of resuscitation efforts and he was declared dead, the Centre for Health Protection said last night.


Preliminary tests were negative for enterovirus and further tests are ongoing, the center added.

The case has been referred to the coroner.

The boy's school has not had any outbreak of hand, foot and mouth disease or flu-like illnesses.

The center has advised the school on thorough disinfection and infection control measures.

Meanwhile, health protection authorities have repeated their call for vigilance against hand, foot and mouth disease following an imported case of enteroviral meningitis in a seven-year-old.

The Hong Kong-born boy who lives and studies in the mainland sought treatment from a hospital there after he developed fever and inflamed cysts on the throat, hands and feet in mid-May.

After initial remission, he developed fever again on May 25 with headache, fatigue, abdominal pain and vomiting, and saw mainland doctors on June 3.

He then came to Hong Kong on Tuesday and was admitted to Tuen Mun Hospital, where tests confirmed the presence of enterovirus.

The boy was in a stable condition last night.

People at his home in Hong Kong have shown no symptoms of the disease.

[Giuseppe]

Hong Kong: Higher number of adult cases attributed to greater incidence of EV infection (6/11/10): genetic mutation not yet proven

Hong Kong: Higher number of adult cases attributed to greater incidence of EV infection (6/11/10)

[Source: Centre for Health Protection, Hong Kong PRC SAR, View Original Article.]

The higher number of adult cases of hand, foot and mouth disease (HFMD) and enterovirus infection with serious complications this year has been attributed to the greater incidence of enterovirus infection overall and not to a genetic mutation of enterovirus.

The Controller of the Centre for Health Protection (CHP) of the Department of Health, Dr Thomas Tsang, said today (June 11) that Hong Kong is experiencing a high season of HFMD and enterovirus infection in 2010 as a result of cyclical epidemic behaviour and regional increase in virus activity.

"Enteroviruses of multiple types are circulating in the community, and EV71 is associated with a higher chance of developing neurological complications," Dr Tsang explained.

"The proportion of adults among cases with neurological complications is not higher than in previous years, and different types of enteroviruses were involved in these adult cases. Genetic sequencing studies of circulating enteroviruses found that they are similar to those in previous years," he said.

"The above analysis indicates that the higher number of adult cases with complications this year is attributable to a greater incidence of enterovirus infection overall and not to genetic mutation of enteroviruses occurring this year in Hong Kong."

The CHP will continue to closely monitor the situation and keep the public updated on the latest situation.

A daily update of the HFMD and EV71 situation has been put up on the CHP website.

To alleviate the impact of the HFMD epidemic, Dr Tsang urged members of the public to maintain strict personal and environmental hygiene to prevent infection, seek medical advice when there are symptoms of HFMD or herpangina, and refrain from going to school or work before all symptoms subside.

He said, "personal hygiene remains the mainstay of measures for parents and other care-takers of infected children and other household members to reduce household infection."
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[Giuseppe]

Hong Kong: Four-year-old boy tested positive for Echovirus 30 (6/11/10): clinically compatible with meningitis

Hong Kong: Four-year-old boy tested positive for Echovirus 30 (6/11/10)

[Source: Centre for Health Protection, Hong Kong PRC SAR, View Original Article.]

A previously reported viral meningitis case involving a four-year-old boy studying in Po Leung Kuk Tam Au-Yeung Siu Fong Memorial Kindergarten in Whampoa Garden, where a hand, foot and mouth disease outbreak was reported, has now been confirmed to be infected with Echovirus type 30, a kind of enterovirus.

Laboratory result issued today by the Centre for Health Protection of the Department of Health confirmed that the boy's throat swab was tested positive for Echovirus type 30.

The boy presented with fever, headache and vomiting since June 6. He was admitted to Kwong Wah Hospital on June 8. No sign or symptoms of hand, foot and mouth disease was noted at that time, but throat and rectal swab showed positive result for enterovirus on June 9. The boy is clinically compatible with meningitis. His condition is now stable. His home contacts are asymptomatic.

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[Giuseppe]

Hong Kong: Two reports of enteroviral meningitis received (6/11/10): 8 year old girl, two month old baby boy

Hong Kong: Two reports of enteroviral meningitis received (6/11/10)

[Source: Centre for Health Protection, Hong Kong PRC SAR, View Original Article.]

The Centre for Health Protection (CHP) of the Department of Health has repeated its call for vigilance against hand, foot and mouth disease (HFMD) as two reports of enteroviral meningitis were received today (June 11).

The first case, one of confirmed enterovirus 71 (EV71) infection, involved an eight-year-old girl who presented with on and off fever and sore throat since June 1. She vomited and complained of headache after convulsion on June 4 and was admitted to Queen Elizabeth Hospital. The clinical diagnosis was viral meningitis. She is currently in stable condition. Viral culture of her nasopharyngeal aspirate today grew EV71 . Her home contacts were asymptomatic. She studies at Maryknoll Convent School (Primary Section) and there was no recent HFMD outbreak.

In the second case, CHP was notified by Tseung Kwan O Hospital (TKOH) today about a confirmed case of EV infection. The patient was a two-month-old baby boy who presented with fever since June 3. He was admitted to TKOH on June 7. The clinical diagnosis was viral meningitis. His cerebrospinal fluid was found positive today for enterovirus. The stool and nasopharyngeal swab was also positive for Coxsackie virus group B type 4. He is still in TKOH and is now in stable condition.

The spokesman called on the public to maintain strict personal and environmental hygiene to prevent HFMD.

They should adopt the following measures:

• Maintain good air circulation;
• Wash hands before meals and after going to the toilet, handling diapers or other stool soiled materials;
• Keep hands clean and wash hands properly, especially when they are made dirty by respiratory secretions, such as after sneezing;
• Cover nose and mouth while sneezing or coughing and dispose of nasal and mouth discharge properly;
• Clean children's toys and other objects thoroughly and frequently with 1:49 diluted household bleach, followed by rinsing/wiping with clean water;
• Children who are ill should be kept out of school until their fever and rash have subsided and all the vesicles have dried and crusted; and
• Avoid going to overcrowded places.

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[Giuseppe]

Hong Kong: Vigilance urged against Hand, Foot and Mouth Disease (6/13/10): 2 additional cases of enterovirus infection with neurological complications

Hong Kong: Vigilance urged against Hand, Foot and Mouth Disease (6/13/10)

[Source: Centre for Health Protection, Hong Kong PRC SAR, View Original Article.]

The Centre for Health Protection (CHP) of the Department of Health has today (June 13) urged the public to stay vigilant against Hand, Foot and Mouth Disease (HFMD) during its current high season as two reports of neurological complications due to enterovirus (EV) infection were received.

The first case was a 13-year-old boy who presented with low grade fever and sore throat on June 10 and later developed headache, rash over hands and feet, drowsiness and dizziness on June 12. The boy attended Accident and Emergency Department of Yan Chai Hospital on June 12, and was then admitted to Princess Margaret Hospital. He was transferred to the Intensive Care Unit today and is now in critical condition. His clinical features were compatible with encephalitis. Investigations revealed that the boy's younger sister had mild fever and sore throat on June 9 and her symptoms had already subsided. Throat and rectal specimens from the boy and his younger sister were preliminarily tested positive for enterovirus but negative for EV71. Further laboratory tests are being conducted.

The second case involved a three-month-old baby boy who developed fever on May 28. He was admitted to Tuen Mun Hospital for persistent fever on May 29. His clinical features were compatible with viral meningitis. He had recovered and was discharged on June 11. His home contacts were asymptomatic. Culture of his cerebrospinal fluid yielded Echovirus type 30.

Echovirus is a type of EV and can also cause HFMD. Complications, which are rare, include meningitis and encephalitis.

The spokesman called on the public to maintain strict personal and environmental hygiene to prevent HFMD.

They should adopt the following measures:

• Maintain good air circulation;
• Wash hands before meals and after going to the toilet, handling diapers or other stool soiled materials;
• Keep hands clean and wash hands properly, especially when they are made dirty by respiratory secretions, such as after sneezing;
• Cover nose and mouth while sneezing or coughing and dispose of nasal and mouth discharge properly;
• Clean children's toys and other objects thoroughly and frequently with 1:49 diluted household bleach, followed by rinsing/wiping with clean water;
• Children who are ill should be kept out of school until their fever and rash have subsided and all the vesicles have dried and crusted; and
• Avoid going to overcrowded places.

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[Giuseppe]

Hong Kong: EV case with neurological complication investigated (6/14/10): 7 year old boy with meningitis and HFMD

Hong Kong: EV case with neurological complication investigated (6/14/10)

[Source: Centre for Health Protection, Hong Kong PRC SAR, View Original Article.]

The Centre for Health Protection (CHP) of the Department of Health is today (June 14) investigating a case of neurological complication suspected to be caused by enterovirus (EV) infection.

The case involved a seven-year-old boy who presented with fever, rash over limbs and sore throat on June 11. He complained headache and nausea subsequently on June 14 and was admitted to Kwong Wah Hospital on the same day. He is now in stable condition. He was clinically diagnosed as meningitis with Hand, Foot and Mouth Disease. Further laboratory tests are being conducted while investigation continues. His home contacts were asymptomatic. The boy studied in St. Patrick's School in Wong Tai Sin where an HFMD outbreak was reported on May 28, involving four boys aged between eight and 12. The onset date of the last case was June 1. Health advice was given to the school and CHP will closely monitor the situation.

The spokesman reminded the public to maintain strict personal and environmental hygiene during the current HFMD high season and adopt the following preventive measures:

• Maintain good air circulation;
• Wash hands before meals and after going to the toilet, handling diapers or other stool soiled materials;
• Keep hands clean and wash hands properly, especially when they are made dirty by respiratory secretions, such as after sneezing;
• Cover nose and mouth while sneezing or coughing and dispose of nasal and mouth discharge properly;
• Clean children's toys and other objects thoroughly and frequently with 1:49 diluted household bleach, followed by rinsing/wiping with clean water;
• Children who are ill should be kept out of school until their fever and rash have subsided and all the vesicles have dried and crusted; and
• Avoid going to overcrowded places.

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[Giuseppe]

Hong Kong: Neurological complication case confirmed EV71 positive (6/15/10): 7 year old boy infected by enterovirus-71 with meningitis and hfmd

Hong Kong: Neurological complication case confirmed EV71 positive (6/15/10)

[Source: Centre for Health Protection, Hong Kong PRC SAR, View Original Article.]

The Centre for Health Protection (CHP) of the Department of Health said today (June 15) that the seven-year-old boy at Kwong Wah Hospital who was clinically diagnosed as meningitis with hand, foot and mouth disease (HFMD) has been confirmed enterovirus (EV) 71 positive.

Latest laboratory result from the CHP's Public Health Laboratory Centre showed that the boy's throat and rectal swab specimen were positive for EV71. The boy is now in stable condition. CHP's investigation continues.

The boy's school, St Patrick's School in Wong Tai Sin where an HFMD outbreak was reported on May 28, will continue to be closely monitored.

The spokesman reminded the public to maintain strict personal and environmental hygiene during the current HFMD outbreaks and to adopt the following preventive measures:

• Maintain good air circulation;
• Wash hands before meals and after going to the toilet, handling diapers or other stool soiled materials;
• Keep hands clean and wash hands properly, especially when they are made dirty by respiratory secretions, such as after sneezing;
• Cover nose and mouth while sneezing or coughing and dispose of nasal and mouth discharge properly;
• Clean children's toys and other objects thoroughly and frequently with 1:49 diluted household bleach, followed by rinsing/wiping with clean water;
• Children who are ill should be kept out of school until their fever and rash have subsided and all the vesicles have dried and crusted; and
• Avoid going to overcrowded places.

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[Giuseppe]

Hong Kong: Kindergarten advised to suspend classes (6/17/10): 1 pupil confirmed with EV-71, 14 other have hfmd

Hong Kong: Kindergarten advised to suspend classes (6/17/10)

[Source: Centre for Health Protection, Hong Kong PRC SAR, View Original Article.]

CCC HK Council Fuk Yau Kindergarten cum Child Care Centre in Tsuen Wan has been advised to suspend classes from tomorrow (June 18) for two weeks until July 1, following investigation by the Department of Health's Centre for Health Protection (CHP) into a Hand, Foot and Mouth Disease (HFMD) outbreak at the school affecting 15 pupils.

The children developed symptoms of HFMD between June 1 and 16. One of the affected pupils was confirmed to have enterovirus 71 (EV71) infection. The pupil was a five-year-old girl who had her infection confirmed on June 12. She consulted private doctor and required no hospitalisation. All affected pupils are in stable condition. No hospitalisation was required.

The school management had stepped up cleansing measures according to CHP's advice following the Centre's visit on June 10 and 14. As three more students were reported today (July 17) to be affected with HFMD, the CHP advised the school to suspend classes from tomorrow for two weeks for thorough disinfection. Investigation continues.

The CHP's spokesman reminded the public to maintain strict personal and environmental hygiene during the current HFMD outbreaks and to adopt the following preventive measures:

• Maintain good air circulation;
• Wash hands before meals and after going to the toilet, handling diapers or other stool soiled materials;
• Keep hands clean and wash hands properly, especially when they are made dirty by respiratory secretions, such as after sneezing;
• Cover nose and mouth while sneezing or coughing and dispose of nasal and mouth discharge properly;
• Clean children's toys and other objects thoroughly and frequently with 1:49 diluted household bleach, followed by rinsing/wiping with clean water;
• Children who are ill should be kept out of school until their fever and rash have subsided and all the vesicles have dried and crusted; and
• Avoid going to overcrowded places.

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[Giuseppe]

Archive. Hong Kong: HFMD and EV71 cases with neurological complications, cases' list (2010)

Hong Kong: Public urged to prevent hand, foot and mouth disease (6/18/10)

[Source: Centre for Health Protection, Hong Kong PRC SAR, View Original Article.]

The Centre for Health Protection (CHP) of the Department of Health today (June 18) called on people to maintain strict personal and environmental hygiene to prevent hand, foot and mouth disease (HFMD) following an investigation into a HFMD case with neurological complications.

The patient is a four-year-old girl who presented with fever, rash over her limbs, sore throat and cough on June 16. On June 17, she developed a headache and was admitted to Princess Margaret Hospital. She is in the Intensive Care Unit and is in serious condition. Her clinical picture was compatible with aseptic meningitis. The throat and rectal swabs of the patient tested positive for enterovirus. Further tests are being conducted.

The CHP noted that the kindergarten the girl attended had no recent HFMD outbreak.

The spokesman reminded the public that Hong Kong was currently in the HFMD high season. He called on the public to maintain strict personal and environmental hygiene to prevent HFMD and adopt the following measures:

• Maintain good air circulation;
• Wash hands before meals and after going to the toilet, handling diapers or other stool soiled materials;
• Keep hands clean and wash hands properly, especially when they are made dirty by respiratory secretions, such as after sneezing;
• Cover nose and mouth while sneezing or coughing and dispose of nasal and mouth discharge properly;
• Clean children's toys and other objects thoroughly and frequently with 1:49 diluted household bleach, followed by rinsing/wiping with clean water;
• Children who are ill should be kept out of school until their fever and rash have subsided and all the vesicles have dried and crusted; and
• Avoid going to overcrowded places.

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[Giuseppe]

Hong Kong: Vigilance urged against Hand, Foot and Mouth Disease (6/19/10): 9 year old boy with EV-71 and meningoencephalitis, 4 year old girl with EV-71 and aseptic meningitis (both in ICU)

Hong Kong: Vigilance urged against Hand, Foot and Mouth Disease (6/19/10)

[Source: Centre for Health Protection, Hong Kong PRC SAR, View Original Article.]

The Centre for Health Protection (CHP) of the Department of Health has today (June 19) urged the public to stay vigilant against Hand, Foot and Mouth Disease (HFMD) during its current high season as a report of neurological complications due to enterovirus (EV) infection was received.

The patient was a nine-year-old boy with good past health who presented with hand, foot and mouth disease in late May. On June 16, he developed headache followed by fever, lower limb weakness, limping gait and drowsiness in the next three days. The boy attended the Accident and Emergency Department of Kwong Wah Hospital on June 19 and was admitted to the Intensive Care Unit. The clinical diagnosis was meningoencephalitis.

He is now in critical condition. Throat and rectal specimens from the boy were tested positive for enterovirus (EV) 71.

The boy studies in Free Methodist Bradbury Chun Lei Primary School in Sha Tin where a HFMD outbreak occurred in May involving five pupils aged seven. The onset date of the last case was May 31.

Health advice was given to the school and CHP will closely monitor the situation.

In another development, a CHP spokesman said the four-year-old girl hospitalised at Princess Margaret Hospital for aseptic meningitis has her throat and rectal swabs tested positive for EV 71. She is currently in Intensive Care Unit in serious condition.

The spokesman reminded the public to maintain strict personal and environmental hygiene during the current HFMD outbreaks and to adopt the following preventive measures:

• Maintain good air circulation;
• Wash hands before meals and after going to the toilet, handling diapers or other stool soiled materials;
• Keep hands clean and wash hands properly, especially when they are made dirty by respiratory secretions, such as after sneezing;
• Cover nose and mouth while sneezing or coughing and dispose of nasal and mouth discharge properly;
• Clean children's toys and other objects thoroughly and frequently with 1:49 diluted household bleach, followed by rinsing/wiping with clean water;
• Children who are ill should be kept out of school until their fever and rash have subsided and all the vesicles have dried and crusted; and
• Avoid going to overcrowded places.

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